Just remember your ABC's If they walk in telling you about their problem, 9 times out of 10 they can wait. Go with your gut instinct, if you think something is wrong, check it out. ER nurses are quick about assessing the situation quickly, but it does take time to get to that point. :chuckle If you loved it when you weren't getting paid, then you'll love it now. But be kind to yourself and allow for a slow transition. Good luck. and BTW, you'll always be scared, and that is why most love the ER.

Apr 17, '03

Congratulations!!!!!

I worked in a small rural West Virginia hospital for about 10 years so I have just a couple suggestions.

1. Get to know all the staff in the hospital during your shifts. Learn their weakness and stregnths. You will need them. Most rural hospital are very slow at night, but what you do get is serious and you will sometimes need extra hands.

2. Get to know your town doctors and how they like to treat their patients. Many times the ER Doc's are rent-a-doc's and they don't really know how the town Doc's want their people treated.

3. If you don't have an OB dept in your hospital. Search out those nurses who have had OB experience and brush up on the topic. You will see a few full-term deliveries that had no prenatal care.

4. Never be afraid to ask questions. The only stupid question is the question you didn't ask.

I had to move for family reasons and now work in a metropolitan hospital, I really miss the family orientation and the professional respect you get from the community. My plans are to return to West Virginia when I retire, and maybe work part-time in a small town hospital. Those were my best years.

Apr 30, '05

Hi! Well I am new to the ER.. I am about 1/2 way done with my 16 week orietnation and I had NO nsg exp except for school. My ER IS the busisest in NJ...hands down.. It really is the biggest challange of my life... The experience and rate that u learn in the er is incredible! You truly never know what is walking or getting rigged thru the door. It is amazing and I have already cried from stress and made mistakes and that is ok... That is the true pace of an ER pace and it truly is an experience. The whole gut instanct advice is priceless. Already my gut has been my savior or my hindsight (Crap, I knew that, or I should have grrrrrrr, or why didn't I?) But, out of all the important advice this is mine... Meds... be soo soo soo soo soo soo careful. Check and check again, question it if your "gut" feels wierd...Know why this pt is getting a med.... and 2nd always think.. what is the worst that can happen and treat for the worst.. ie pt with chest pain think MI... pt with SOB or pain think PE.... because one time it will be that worst and u will have done your duty well!! MEDS #1 ... ok so if u skip assessing bowel sounds what is the worst that can happen.. if you mess up a med what is the worse that can happen. My drug book is my bible.... ALWAYS carry it with u! Good LUCK!!! You'll do awesome!

May 2, '05

[QUOTE=abnurse]Hello from the Hills!

I have just accepted my first position as an ER nurse and am excited and terrified at the same time. I have minimal ER experience...I precepted 60 hours in the busiest ER in the state and loved it.

Anyone have any good advice to give a soon to be graduate nurse (May 10, 2003) that will help me transition from the student thinking to the emergency nurse thinking.

I wish you the best. Be patient with yourself. You will wanto to know it now-but nobody expects you to be perfect. Be ready to soak it all up. Treat each patient like its the first one for the shift. Be ready to move fast, but be steady and sure with your meds and procedures. Figure out who the more approachable nurses are and who likes to share their knowledge and teach. If you are unsure why something was done or ordered or need to refresh on the pathophys part, go home and look it up-after awhile you won't believe how it all starts to fit, and what you already know.
I found a job I love in the ER and it took me awhile to feel the confidence. I had a lot to give and couldn't because I was allowing myself to be overwhelmed. I am just finishing up my orientation this month and can't believe how much I have learned. I love going to work and I love the people surrounding me-they might be busy but everyday most of them are teaching by actions and their good example. Try to break it down into weeks-this week I am going to do this....next week I will add on this.
Good luck and in a few months, you will start to see the "fun" and challenge. You will feel like a part of a team and not just this new kid on a very established block...and if you shed a few tears, its ok...it shows you care and want try harder. Also, its ok to laugh too. Find some humor in your day or with another staff member-it really keeps things going.
if you can, get a pocket pc or palm, load a drug guide on there and that is where i put all my notes, and download an RN notes or ER/critical care software for quick references. Its so much easier to have this all in your pocket if you need it...
Good luck!!
K~

May 7, '05

HI. I 'm also just finishing school and did an internship at the nation's 6th busiest ED in Colorado. The staff there knows me from my other job and they are all encouraging me to start the training program. I'm feeling like they have more faith in me than I do, especially after the fast pace crash course of a clinical, but I'm so excited to jump in. You seem to have the same situation as I do. I've been kicking that old accepted idea that you always need to do a year of med/surg right out of school for a base knowledge, but there are ED nurses there that started in the ED. The charges all told me, "don't worry, you'll get the skills along the way...." sure, easy for them to say... let me know how it's going, i'm curious to see how we'll compare with the one year med/surg crowd and good luck.

May 7, '05

Well I will be an ER newbie also starting the 16tgh so I will pray for you and you can pray for me!!!!!

Quote from abnurse

Hello from the Hills!

I have just accepted my first position as an ER nurse and am excited and terrified at the same time. I have minimal ER experience...I precepted 60 hours in the busiest ER in the state and loved it.

Anyone have any good advice to give a soon to be graduate nurse (May 10, 2003) that will help me transition from the student thinking to the emergency nurse thinking.

I have a minimum 16 week orientation in a smaller rural hospital than I precepted in but am terrified that I will be swallowed whole by the expereinced nurses.

Any advice you can give me will be of great help.

Thanks and wish me luck as I venture into the jungle of the truly sick, whacked out and those just seeking attention.

May 8, '05

i am older than dirt and when i started i was very young. i had a really hard time at first. i was almost eaten alive by the old nurses. er rn's tend to be judgemental, impatient, rediculous expectations.... oh wait, that is me now!

i guess what i am trying to say is don't let us intimidate you! stick with it and you will find the er to be the greatest place in the world to work. remember, easy things aren't generally worth doing anyway!

just have fun!

remember: life has a lot to offer but it won't come and find you. you have to find it!

May 10, '05

Quote from nursejennie76

Well I will be an ER newbie also starting the 16tgh so I will pray for you and you can pray for me!!!!!

I am a newbie also, I start in 3 weeks. Maybe we can start a new ER nurse support group. :chuckle I am almost as scared of the staff as I am of the learning curve ahead of me. I am going to try to just learn what I can and dodge the punches, surely they can't all be mean. I LOVE the ED so I know I will survive.
Good Luck to you guys!

Last edit by Happy-ER-RN on May 15, '05

May 11, '05

Good luck - ER is the hardest place to start because there is so much to learn right out of school - but you will also find that in a couple months you will be miles ahead of your fellow GNs.

Do find which nurses want to help you learn - make friends with the Techs, they can really help - be nice to the clerks - ask any question that you think of, even ask "is there something else I should be questioning here?"

ER can be a very high stress environment - don't take it personally when you get your head handed to you on a plate ... we all get it at times. Learn to laugh, don't take yourself too seriously - take your practice very seriously.

Will re-iterate that a Palm is a great tool in the ER - carry a drug book, lab reference, pathophys, formulas, etc - all in a pocket.

Have fun - it's a wild ride!

May 17, '05

That's a great idea....!!! Let's get a forum started for ER Newbies.... like us. I start on June 21st with orientation then enter the grueling training program. I'll email the webmaster....

Quote from Happy-ER-RN

I am a newbie also, I start in 3 weeks. Maybe we can start a new ER nurse support group. :chuckle I am almost as scared of the staff as I am of the learning curve ahead of me. I am going to try to just learn what I can and dodge the punches, surely they can't all be mean. I LOVE the ED so I know I will survive.
Good Luck to you guys!